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One capsule a week? I get a prescription as well, and it's 2 capsules a day (total: 1000 mg calcium, 400 I.U. Vitamin D) -- my doctor has me take it because I've been on Viread for 8 years (actually Truvada for 5 years) and Viread has the potential side effect of bone issues. I'm curious, and concerned Ray, that if you're already testing deficient in this regard why your doctor has you on such a minimal amount when you're also on Viread like I am.

One capsule a week? I get a prescription as well, and it's 2 capsules a day (total: 1000 mg calcium, 400 I.U. Vitamin D) -- my doctor has me take it because I've been on Viread for 8 years (actually Truvada for 5 years) and Viread has the potential side effect of bone issues. I'm curious, and concerned Ray, that if you're already testing deficient in this regard why your doctor has you on such a minimal amount when you're also on Viread like I am.

J.R.E's doctor is right actually.

Vitamin D is fat soluble, which means it accumulates in the body. Essentially, it doesn't make much of a difference to take one large dose weekly or smaller doses daily.

A dose of 50,000 IU a week is 7142 IU per day, which is fairly high.

The R.D.A for vitamin D is 400 IU, which is what you are taking - 1/17th as much. The R.D.A is way underestimated, IMO, and certainly not enough to make up for any deficiencies caused by medications.

Without knowing your respective vitamin D levels, it's hard to know the best D supplementation dose you need to take. I had several vitamin D blood tests taken. My first one was at 12ng/ml - where normal is 30-100. This was considered a severe deficiency. I started around 800 IU/day, and it did squat. 6 months later I was at something like 13 ng/ml. I had to increase the doses gradually and get several more levels. Today I am taking about 5000 IU/day, every day of the year. My D levels are in the 40 to 65 ng/ml depending on the season. I get the levels checked at least twice a year. My deficiency is caused by several meds that I take daily : prilosec and tegretol, as well as the fact that I am very sedentary and seldom get out in the sun. If I ever get on HIV meds I may have to increase my D supplementation beyond 5000 IU.

When it comes to D supplements, all are not equal. There are several things that are helpful to know.

1) D3 is better than D2 . Most over the counter D supplements are D3 . That's because the D3 is the natural form, and the D2 needs to be converted by the body. The prescription ones with high doses like 50,000 are usually D2. So, the OTC ones are actually better !

2) For D3 supplements, the softgel forms have much better bioavailability than most tablet forms.

The D3 supplement I have settled on is from NOW foods, and is a single 5000 IU softgel that I take daily. That's the highest IU D3 supplement I could find in a single gel. A one-year supply runs me only $27 at iherb.com.

You can also buy good D3 supplements at most drugstores - just make sure to buy the softgel form. Walgreens sells some 1000 IU and 2000 IU supplements in softgel form that are usually affordable and often on sale (buy 1 get 1 free). The NOW foods 5000 IU is still a better deal, but you have to order it online. If you need less IU than 5000, just don't take it every day.

High Prevalence of Vitamin D Deficiency in HIV-Positive Menby David Evans

Nearly half of a group of HIV-positive men in New York City had abnormally low levels of vitamin D—potentially leaving them at risk for developing bone problems, according to a study presented at the Fifth International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment and Prevention in Cape Town.

Bone problems are a growing concern for people with HIV. This is partly because researchers are finding that people with HIV have bone problems at a younger age than their HIV-negative counterparts. In addition, people with HIV are also living to the age that uninfected people begin to have bone problems. Vitamin D is a critical part of bone health. Without it, the body cannot absorb calcium, which makes up the structure of all bones. Vitamin D deficiency is common in Northern latitudes because of the lack of sunlight during winter—the sun is a main source of vitamin D for our bodies.

To determine the prevalence of low vitamin D levels, David Rubin, MD, from the New York Hospital Queens, and his colleagues enrolled 62 HIV-positive New York City men into a study: 92 percent were on ARVs, nearly half were Hispanic, and 16 percent were black. The average age was 48, and the men’s body mass index—a calculation of weight and height—was 26.4, just slightly heavier than the normal range. A low body mass index is associated with poorer bone health.

Overall, 42 percent of the men in the study had vitamin D deficiency, with 11.3 percent having severe deficiency. After considering factors such as low CD4 count and BMI, researchers found a trend toward greater vitamin D deficiency in people who had taken non-nucleoside reverse transcriptase inhibitors (NNRTIs), such as Viramune (nevirapine) and Sustiva (efavirenz) compared with protease inhibitors. Smoking also was highly correlated with extremely low vitamin D levels.

The authors recommend routine clinical screenings for vitamin D in HIV-positive patients. They also call for further research to explain or debunk the connection between NNRTIs and vitamin D deficiency.

how low of vit D is considered a defficiency that needs be treated? I tested 30.3 (normal 32-100).. Is that low enough to get treated and if so - would a normal 400-600 iu found in an average multi suffuce or do I need the "stronger" stuff??

Here is a good overview about vitamine d --- a long read but worth the time. 30.3 seems low. My Docwanted me to be in the 50 range. To maintain that level I had to take over 1000 iu/day. Of course review with your own ID.

how low of vit D is considered a defficiency that needs be treated? I tested 30.3 (normal 32-100).. Is that low enough to get treated and if so - would a normal 400-600 iu found in an average multi suffuce or do I need the "stronger" stuff??

You are not really deficient. You are just at the bottom range. There is no urgency to do anything. If you want to have a higher D level, in the middle of the range, you will probably want to take a bit more than 400-600 IU. Maybe 1000-2000 IU. But it varies depending on how much sun exposure you get, what meds you take, etc. You'll need to experiment with your D intake and check your level again to find what's best for you. You'll need to have your level checked again to do that.D levels tend to be lower in the winter so that would be a good time to recheck. You might come out deficient then if you make no changes to your D intake or sun exposure.

what number is considered deficient then? and also - what time intervals in testing can show changes in D levels (for example: if I started taking a 400-600 iu multi vitamin or a stronger 1000-1200iu one - would one month retesting show the new level I reached or does it take longer??)

My Kaiser labs say the normal range is 30 to 100, almost the same as your lab which says 32 to 100 . At 30 you are really just at the bottom of the range, but not deficient.

Quote

and also - what time intervals in testing can show changes in D levels (for example: if I started taking a 400-600 iu multi vitamin or a stronger 1000-1200iu one - would one month retesting show the new level I reached or does it take longer??)

You probably want to ask your doc about it, there are just a lot of factors that affect absorption and depletion of vitamin D. I would recommend you don't wait too long for your test. 1 - 2 months may be OK. But not 6. You will need several tests to determine how much you need per day to maintain your target D level.

I was diagnosed with severe deficiency with a level of 11 back in 01/2007. I took from 800 to 1200 IU daily. My repeat test was at 6 months, in august, and my level was only at 12 ! Basically the small 800 - 1200 IU dose wasn't doing anything. In retrospect I should definitely not have waited that long to retest. My doc and I just thought the doses were OK since they were 2 - 3x of RDA, but the RDA for vitamin D is way underestimated IMO. I think vitamin deficiencies were tested by the CDC on military personnel, which must have been out in the sun quite a bit. The RDA clearly doesn't match for sedentary office workers like me !

I then switched to taking much larger doses, to about 5000 IU per day. That's what I still take right now. My highest level has been around 75, my latest one was only 44 which I thought was quite low for summer, it's the lowest level I have for over a year. I get very little sun exposure. I may switch to an even larger dose next winter.

I saw my ID Dr today and of course I brought up the Vit D issue (i.e. my blood levels being slightly below minimums). He said he wants me to start taking 4000iu a day for a month and then 2000iu thereafter. Retesting in 3 months (with routine lab work) to assess results. He also prescribed me Calcium 600 and Niacin 500 (the latter due to slightly elevated LDL>100).

why wouldn't you just get your vitamin D free from exposure to the sun?

For me, it's because I work 11:00 pm to 7:00 AM , five days a week. And sleep during the day. I get very little sun on the two days I have off. But, I guess it for the best anyways, considering all the skin cancers I've had in the past. Can't take too many chances these days.

"If you're fair skinned, experts say going outside for 10 minutes in the midday sun—in shorts and a tank top with no sunscreen—will give you enough radiation to produce about 10,000 international units of the vitamin."

So 1000 IU is the equivalent of about one minute in the sun under those conditions. It's really not all that high of a dose.

"If you're fair skinned, experts say going outside for 10 minutes in the midday sun—in shorts and a tank top with no sunscreen—will give you enough radiation to produce about 10,000 international units of the vitamin."

I'm not sure where (as in what location) they would recommend such exposure. I live about 33 degrees south of the equator and that amount of sun in the middle of the day would be way too much and lead to sunburn.These are the general recommendations in Australia - the US is spread over a similarly vast range of latitudes. Hence I asked my question re the need for supplements as it seems so easy to get the required amount from normal lifestyle acitivities.

Vitamin DThe sun's ultraviolet (UV) radiation is both the major cause of skin cancer and the best source of vitamin D. How much sun do we need for healthy bones?The best source of vitamin D is UV-B radiation from the sun. UV radiation levels vary depending on location, time of year, time of day, cloud coverage and the environment.

For most people, adequate vitamin D levels are reached through regular daily activity and incidental exposure to the sun. During summer, the majority of people can maintain adequate vitamin D levels from a few minutes of exposure to sunlight on their face, arms and hands or the equivalent area of skin on either side of the peak UV periods (10am to 3pm) on most days of the week.

In winter in the southern parts of Australia, where UV radiation levels are less intense, people may need about two to three hours of sunlight to the face, arms and hands, or equivalent area of skin, spread over a week to maintain adequate vitamin D levels. In winter in northern parts of Australia, people will continue to maintain adequate vitamin D levels going about their day-to-day activities, so it is not necessary to deliberately seek UV radiation exposure.

Who is at risk of vitamin D deficiency?Some people may not be able to access the sun exposure required to help them maintain their vitamin D levels. These groups may be at risk of vitamin D deficiency. They include:

naturally dark skinned people - who need more UV exposure to produce adequate levels of vitamin D as the pigment in their skin reduces UV penetration people who cover their skin for religious or cultural reasons the elderly and people who are housebound or in institutional care babies and infants of vitamin D deficient mothers, especially breastfed babies patients with osteoporosis. People in these groups should consult their doctor for advice on whether they need to take a vitamin D supplement.

My concern is that I'm leaning toward the belief that these values are still too low and that there is benefit to be derived from a higher vitamin d level. What are your thoughts ? The more research being done on this vitamin, the more evidence there seems to promote this belief.

fearless,

What are the ranges used in Australia ? Have you had your levels checked? I agree that outside activity is probably the best way to get the right amount of this vitamin, however, that's not always practical here.

Did you get your Vitamin D level through a Nutrient Panel (I think that is what it is called)? I asked my Dr about having a Nutrient Panel done but he was very, very hesitant because it is so expensive. Is there another test that can be done?

Did you get your Vitamin D level through a Nutrient Panel (I think that is what it is called)? I asked my Dr about having a Nutrient Panel done but he was very, very hesitant because it is so expensive. Is there another test that can be done?

It was just another test added to one of the quarterly blood draws for me -- the report gave two results for:Vitamin D 25-HydroxyVitamin D 1,25 DiHydroxy

Did you get your Vitamin D level through a Nutrient Panel (I think that is what it is called)? I asked my Dr about having a Nutrient Panel done but he was very, very hesitant because it is so expensive. Is there another test that can be done?

No. I just get the vitamin D level checked specifically. My doctor never had an issue ordering that test because I take several medications that deplete vitamin D (tegretol, prilosec). I get it checked at least twice a year if not more.

Got my blood drawn last week (I go every 3 months) Got the results today CD-4: 385 VL: Undetectable. Started on Atripla and have been on it for 1 1/2 years. Bloodwork showed very low Vitamin D level so Dr. wrote me a prescription for Vitamin D.

Per this article Vitamin D is a miracle drug! Glad I started taking it.....

Our national “health” officials (if you can call them that) are making a crucial mistake with the swine flu. Instead of ordering more vaccines, they should be recommending vitamin D supplements to the population. For less than the cost of the vaccines, we could provide vitamin D supplementation to every man, woman and child in America. We would not only end the swine flu pandemic, we would also see cancer rates plummet!

Perhaps that’s why our health authorities don’t dare recommend vitamin D — the financial impact on the cancer industry would just be too great. The vaccine makers would lose billions, and the cancer industry could lose tens of billions. Diabetes rates would fall, depression would fade away in many people, kidney function would improve and a long list of other diseases would be prevented or reversed following adequate vitamin D intake.

Vitamin D is the answer to our national health care problems. Just one nutrient, if distributed freely to everyone, could probably slash our national health care costs by one-third within five years, I believe.

That article seems rather low on evidence. While I'm not going to knock down vitamin D - I take plenty of it myself, I haven't seen any proof that it is as efficaceous as preventing the flu as a flu vaccine. I'll take both the D and the vaccine, thank you very much.

Miss P,Do you know how to do research? Your comments are lacking substance.

On the contrary evaluating the credibility of a source is a key component of research. Posting links to sources without evaluating the credibility of those sources provides no added value above that afforded by a search engine.

Your evaluation must be backed-up by some reference. If not, it is just your opinion and meaningless. Evidently, if you had read my second link, you would have realised that there is some validation to vitamin d and H1N1. Look beyond the obvious ! You must have missed my statement:"You be the judge".

Your evaluation must be backed-up by some reference. If not, it is just your opinion and meaningless. Evidently, if you had read my second link, you would have realised that there is some validation to vitamin d and H1N1. Look beyond the obvious ! You must have missed my statement:"You be the judge".

v

Oh come now, V. You published a link to a source full of hyperbole. That sort of a reference doesn't make any opinion meaningful. The next several posters commented on the overstatements in that link.

That there is research going on into the validity of a hypothesis does not validate that hypothesis. Vitamin D has been the subject of many claims of improbable capabilities -- research into which of those claims might have some basis is a good thing -- but it does not imply validation.

On the contrary evaluating the credibility of a source is a key component of research. Posting links to sources without evaluating the credibility of those sources provides no added value above that afforded by a search engine.

And where do you see that I have validated their research and statements? I am providing information on a topic that has just come to light fairly recently and enough researchers are interested to take the studies to the next level. Of course they exaggerated the claims, however, when claims like this are made, there is usually a modicum of truth and come to find out that truth does exist based on the next level of research being done. I believe the second link validates that. Will it work ? The trials will tell. Don't ever dismiss information outright without further investigation, especially if the info concerns a timely topic in the mainstream. I hope people use discretion when reading these posts and certainly make no decision until running it by their IDD. You have to be the judge as to what you read in these forums. Further research is usually needed to make that judgement. By the way, have you ever read some of the hyperbole that comes out of clinical trials? If you still have concerns about the level of vitamin D studies ---- try this link

Just to clarify, I think there are legitimate studies suggesting that people with HIV may suffer from vitamin D deficiency. And personally, based on a link to a study (posted by Miss P, BTW) I went down the whole road of testing for osteoporosis and then looking for causes including vitamin D deficiency. I was tested by my doctor, diagnosed as deficient, and am on a supplement.

There have been more studies suggesting potential vitamin D deficiency in poz folks since then. I heartily encourage all poz people to get their vitamin D levels tested. It's could be important for a lot of us.

But I also think that some of the more outlandish claims should be treated more warily. Links like the one you published encourage people to just add vitamin D for all of the (untested) good effects, regardless of whether or not they are vitamin D deficient. And frankly, given that a test for deficiency is simple, inexpensive and can be added to the regular blood tests that poz people are getting anyway, it doesn't make sense to me to encourage people to take vitamin D before finding out whether they are deficient in it or not.

Regarding "And where do you see that I have validated their research and statements?" sorry if you took away the wrong impression. You had said: "Evidently, if you had read my second link, you would have realised that there is some validation to vitamin d and H1N1. Look beyond the obvious " Your second link pointed to a study of the efficacy of vitamin D in swine flu. My response to you said "That there is research going on into the validity of a hypothesis does not validate that hypothesis." It was not intended to indicate any belief that you had personally validated the research and statements.

I have to admit that the more I read about vitamin d, the more interested I become. I'm just not sure what the right dose is. Madbrain seems to be on the right track and I'm toying with doubling my dosage.Well that's something I'll have to work out.

There was a blurb about vitamin D in a story about osteoarthritis today in the Globe:

...At Tufts Medical School, Dr. Timothy McAlindon, chief of rheumatology, is wrapping up a clinical trial of vitamin D on 146 patients and its potential effect on heading off osteoarthritis by building up cartilage. His curiosity was piqued after reviewing historic data from another study involving heart disease and found that patients who took higher levels of vitamin D appeared to fend off knee osteoarthritis.

Some of McAlindon’s earlier osteoarthritis research involving glucosamine and chondroitin - he analyzed 15 studies on the supplements - found mixed results. McAlindon is focusing his research on relatively safe over-the-counter supplements to build cartilage because, he said, that’s what consumers seem to be searching for.

For his own osteoarthritis patients, McAlindon said he finds many have inadequate levels of vitamin D, so he often prescribes booster courses of the supplement. “Vitamin D is important for bone health, but it may be important for other aspects of health,’’ he said. “You can never tell until you do that controlled, clinical trial.’’.....

The dr gallant /johns hopkins website says for him the most important supplements to take are vit d and calcium and says a multi vit wont do you any harm but a very high % of his hiv patients lack vit d and calcium. This guy really knows his stuff and it prompted me to get a bone density test ,vit d and calcium test ,results pending. At the same time i tested for selenium which apparently alot of us lack and testorone,i will let you know the results.